S09 Insights into the development of the physical activity environment policy index, a tool for benchmarking implementation of public policies to create healthy physical activity policy environments

Abstract The UN Sustainable Development Goals' (https://sustainabledevelopment.un.org/) and the Global Action Plan on Physical Activity (https://www.who.int/ncds/prevention/physical-activity/gappa) highlight the need to move beyond individual behaviour change to broader policy and system approaches, focusing not only on health but also on sustainability. Recently, policy responses to the epidemics of physical inactivity and sedentary behaviour have grown. The Global Observatory for Physical Activity (GoPA) reports that by 2013, 139 countries were members of its physical activity advocacy alliance and 26.6% of these countries had already published a stand-alone physical activity plan. The ‘Policy Evaluation Network' is a multi-disciplinary European research network aimed at understanding the impact of public policy for promoting healthy lifestyles in an effort to prevent non-communicable disease. To understand the progress governments are making in creating healthy policy environments, the benchmarking of best practice has proven effective for advancing the food policy agenda; however its usefulness for physical activity requires evaluation. Individual country results promote mutual learning between countries. This symposium will take a deep look at public policy in physical activity. It will summarise evidence from systematic literature reviews and present a tool for benchmarking progress. It will also discuss the potential next steps for addressing the inactivity, obesity and climate challenges through policy solutions in a systematic way. The Chair will give an overview of context within which this symposium takes place e.g. GAPPA, Policy developments etc. They will also explain the symposium's purpose and objectives, introduce the speakers and direct questions. Symposium Objectives 1. To review evidence for the contribution of transport, sport and mass media policy to the promotion of physical activity. 2. To show how evidence generate in each of these reviews contributed to the development of the physical activity environment policy index (PA-EPI). 3. To discuss the next steps for addressing inactivity by using policy intervention as a tool to catalyse change. Abstract 1: Which transport policies increase physical activity of the whole of society? A Systematic Review. Abstract 2: The impact of mass-media campaigns on physical activity: a review of reviews through a policy lens. Abstract 3: Evidence of the impact of Sport Policies on physical activity and sport participation: A Systematic Mixed Studies Review. Abstract 4: The development of the Physical Activity Environment Policy Index (PA-EPI): a tool for monitoring and benchmarking government policies and actions to improve physical activity. The Discussant summarizes the presentations and provides insights on the specific topic area, generating an interactive discussion with the audience for at least 15 minutes, moderated by the Chair. (15 minutes) Conclusions: Some discussion of the possible contribution to, or implications for, the advancement of HEPA related goals.


Background
Increasing number of studies use device-based measurements to report levels of physical activity (PA) and sedentary behavior (SB) of populations. The studies have used different devices, device placements and analysis methods, and thus the comparison of the results between studies and populations is very challenging. The purpose of the present study was to present preliminary results of PA, SB and sleep-time measured with a similar method among adults of 16 European countries.

Methods
The study is based on the Eupasmos-project where PA, SB and sleep-time of the participants (n = 6674) were measured by a tri-axial accelerometer 24/7 (UKK RM42, UKK Terveyspalvelut Oy, Tampere, Finland). Accelerometer was worn on an elastic hip-band during waking-hours and on a wrist-band attached to a non-dominant wrist during bed-time (sleeping). PA-parameters were based on mean amplitude deviation (MAD) of acceleration analyzed in 1min exponential moving average (epoch length 6s). Assessment of SB (e.g. sitting and laying down) and standing were based on the angle for posture estimation (APE). Sleep measurement was based on the movement of a non-dominant wrist during bed-time. Parameters analyzed were total daily times and different bout lengths of SB, standing, light PA, moderate-to-vigorous PA, sleep and mean number of daily steps.

Results
The preliminary analysis included 47-1952 participants/ country. In all countries participants spent most of their waking-hours sedentary. On weekdays the country-mean of SB varied from 8h18min to 10h7min. Participants took on average 6907-9716 steps/day. Light PA varied from 3h46min to 5h10min and moderate-to-vigorous PA from 45 to 78min. Participants wore the device on their wrist (sleeping-time) 6h42min-8h37min on weekdays. Although the total times of these behaviors were quite similar between the countries, the variation increased when different bout lengths were analyzed: the longer the bout length, the larger the variation. The hourby-hour pattern of these behaviors varied a lot between the countries as well.
Abstract citation ID: ckac093.043 S08-4 In terms of individual fitness, people with low cardiorespiratory fitness are physically the most active

Background
Depending on cardiorespiratory fitness (CRF), people may perceive differently the exertion of incident physical activity (PA). It has been proposed to use thresholds relative to individual fitness in PA monitoring when it is feasible. Methods 1952 adults (803 men, 1149 women), aged 20-69 years participated in the FinFit2017 (EUPASMOS) -study. Their VO2max was predicted with 6 min walking test and they had accelerometer wear time at least four days with minimum of 24 h/day during seven consecutive days of measurement period. The participants were divided into CRF thirds by age groups and sex. Acceleration data was analyzed in 6s epochs and intensity in MET (metabolic equivalent) values was calculated for each epoch. MET values were smoothed with 1min exponential moving average. The epoch activity was classified into moderate-to-vigorous PA (MVPA) using both absolute (3.0MET) and individual (40% of the oxygen uptake reserve) thresholds. The accumulated MVPA time was calculated for bouts at least 0.1, 1.5, 3.0, 5.0, 10.0, 15.0, 20.0, 30.0 and 60.0 minutes. Population-weighted average of accumulated PA times in CRF-thirds and partial Spearman correlations controlled by age and sex between bout lengths and VO2max were calculated for both absolute and relative thresholds.

Results
Participants in the lowest CRF-third accumulated the most (p > 0.05) MVPA time with relative threshold (22min (low); 15min (middle); 12min (high)) and the highest third (40min (low); 50min (middle); 56min (high)) with absolute threshold. The correlations were negative with individual thresholds, if short bouts were counted into accumulated time, and significant positive correlation (r = 0.048) was achieved only with at least 60.0min bouts. The correlations were significantly positive for all bout lengths with absolute thresholds and the highest correlation was achieved with at least 0.1min bouts (r = 0.295).

Conclusions
The lowest fitness third was the most active when the PA intensity was analyzed using relative thresholds. Their PA was Thus, they basis just The UN Sustainable Development Goals' (https://sustainabledevelopment.un.org/) and the Global Action Plan on Physical Activity (https://www.who.int/ncds/prevention/physical-activity/gappa) highlight the need to move beyond individual behaviour change to broader policy and system approaches, focusing not only on health but also on sustainability.
Recently, policy responses to the epidemics of physical inactivity and sedentary behaviour have grown. The Global Observatory for Physical Activity (GoPA) reports that by 2013, 139 countries were members of its physical activity advocacy alliance and 26.6% of these countries had already published a stand-alone physical activity plan. The 'Policy Evaluation Network' is a multi-disciplinary European research network aimed at understanding the impact of public policy for promoting healthy lifestyles in an effort to prevent noncommunicable disease. To understand the progress governments are making in creating healthy policy environments, the benchmarking of best practice has proven effective for advancing the food policy agenda; however its usefulness for physical activity requires evaluation. Individual country results promote mutual learning between countries. This symposium will take a deep look at public policy in physical activity. It will summarise evidence from systematic literature reviews and present a tool for benchmarking progress. It will also discuss the potential next steps for addressing the inactivity, obesity and climate challenges through policy solutions in a systematic way. The Chair will give an overview of context within which this symposium takes place e.g. GAPPA, Policy developments etc.
They will also explain the symposium's purpose and objectives, introduce the speakers and direct questions. Symposium Objectives 1. To review evidence for the contribution of transport, sport and mass media policy to the promotion of physical activity. 2. To show how evidence generate in each of these reviews contributed to the development of the physical activity environment policy index (PA-EPI).

Background
There is strong evidence of the links between car-dependence and the global physical inactivity epidemic. If eliminated, physical inactivity would remove between 6% and 10% of major non-communicable diseases that are the leading cause of death globally, killing 38 million people each year. Research consistently shows that unlike passive transport (e.g. driving a car), active transport (i.e., walking, cycling) is associated with higher total daily physical activity (PA). While there are public policies that support PA in transport and, as a result, overall PA levels, the specific quantitative effect of such policies on PA behaviour has not been sufficiently investigated. The aim of this systematic review is to determine the level and type of evidence for policies in the area of transport that contribute to higher PA levels of society at large.

Methods
Six databases (MEDLINE (Ebsco), SportDiscus, Cinahl, Cochrane library, Web of Science, and Scopus) were searched for key concepts of policy, transport, evaluation and PA. Methodological quality was assessed using standardised tools. The strength of the evidence of policy impact was described based on pre-determined categories of positive, negative, inconclusive or untested. Results 17 of 2,549 studies were included in the data synthesis. The authors identified three main transport policy areas with 60 individual policy actions that had a direct or indirect effect on PA. The policy areas were: convenient transport infrastructure development, active travel promotion and shift of transport mode. These areas correspond to Haddon's methodological approach of the transport system division in to three elements (human, vehicle, road). More than half of the policy actions identified (53%) had a positive effect on PA. Study quality ratings were moderate to good. Conclusions PA levels can be increased by implementing policies that provide convenient, safe, and connected walking and cycling infrastructures, promote active travel and give strong support